Tonia Young-Fadok, Professor of Colorectal Surgery at the Mayo Clinic in Phoenix, Arizona and Past President of Enhanced Recovery After Surgery Society (ERAS®) USA, is delivering the keynote lecture, ‘Prehabilitation, nutrition, and optimisation for major surgery’ at the ESCP Scientific and Annual Meeting in Vienna on Thursday 26 September.
Young-Fadok will split her highly anticipated keynote session into three key sections; pre-habilitation, nutrition and optimisation. She is extremely passionate about perioperative care and enhancing postoperative recovery through the implementation of evidence-based practice, audit, education and collaborative research.
Young-Fadok explains:
“It’s vital that colorectal surgeons become increasingly aware of these distinct areas which are greatly enhancing patient functionality and recovery post-surgery.
“Evidence and guidelines show that pre-operative optimisation plans should be implemented as early as possible to ensure patients are as healthy as possible ahead of a major surgical procedure. For example, if a patient smokes or drinks alcohol excessively, this should be corrected for a significant lead time (on average four weeks pre-surgery) which can make a considerable difference to their overall recovery.”
Surgeons should also be conscious of providing the appropriate dietary advice which should be tailored to each patient’s medical condition and lifestyle. Young-Fadok goes on:
“Attempting to correct nutritional deficiencies is a delicate balancing act and patients should be screened ahead of major surgery to identify potential risks. Many colorectal surgery patients are malnourished - especially in the setting of obstructing/metastatic cancer or inflammatory bowel disease. There is a fine balance between attempting to improve nutritional status versus urgency to address the inciting cause.”
The field of pre-habilitation has been fraught with trials reporting improvement in specific, sometimes highly selective exercises pre-operatively, with no noticeable improvement in meaningful post-operative outcomes.
Some recent evidence suggests possible unexpected improvements in long-term outcomes now that mature data is becoming available. Young-Fadok aims to raise awareness of this in her presentation in Vienna.
She ends with a call to action:
“We must promote a culture of inclusivity that recognises the importance of multi-professional and multi-disciplinary collaboration across silos. Evidence-based guidelines should be followed as a matter of course to ensure the best outcomes for patients wherever they are. It is down to those individuals, usually surgeons, with the power to implement change to do so.”
Keynote Session: Prehabilitation, nutrition, and optimisation for major surgery
Date: Thursday 26 September
Venue: Plenary Hall A
Time: 17.05 - 17:35
